Shapiro, a clinical psychologist, knows this landscape firsthand. For five years when he was in his 20s, he battled lymphatic cancer, undergoing chemotherapy and a bone marrow transplant and relying upon his spouse Terry for support. A dozen years later, the roles were reversed when she was diagnosed with breast cancer.

“Despite living in the cancer world since the 1980s, I underestimated how intense, painful and difficult it is to be the spouse and how important it is to understand that both roles are challenging,” said Shapiro, who is also chairman of the Department of Humanities at Penn State College of Medicine.

“We’re talking about really practical things we can do to make the experience easier and strengthen our relationship.”

Those “practical things” range from how to interact with the medical team and deal with emotions to how to talk about sex, to name a few of the chapter topics. The chapters themselves contain a mix of personal anecdotes, research findings and specific recommendations such as working less to scheduling weekly date nights when talking about cancer is prohibited.

All are aimed at helping couples navigate this unfamiliar and scary terrain that can include radical body changes, job loss, and role shifts.

While Shapiro draws on his personal experiences to frame the book, he also consulted the research literature and interviewed 40 couples coping with cancer. Quotes from those interviews provide additional insight into how people can anchor themselves in the face of trauma.

“Every patient I interviewed contributed. Many had insights they didn’t think of as unique but were very helpful, and there were people who were in situations that I had not encountered,” Shapiro said.

And despite the seriousness of the topic, the book has real moments of humor, another coping strategy that keeps people oriented to what is important. Noted one interviewee, for instance, “I was cooking for Nancy. That may have been worse for our health than the cancer.”

Shapiro acknowledges that just as some people do not survive cancer, some relationships also do not survive. But he holds out hope that couples can learn the skills that will strengthen their relationships and help them move through the crisis.

“Cancer is like a typhoon -- nothing prepares you for this level of vulnerability,” Shapiro said. “But we can find new bearings when we face this unknown with someone we love, someone who makes us laugh, someone who stands with us shoulder to shoulder.”